Diagnostics最新文献

{"title":"Prediction of Six-Month Glycemic Status in Type 2 Diabetes: Development and Internal Validation of a Multivariable Model.","authors":"Andreea Diana Igna, Bianca-Lăcrimioara Petca, Paula-Alexandra Popovici, Ioana Moga, Titus David Moga, Timea Claudia Ghitea, Corina Cinezan, Mihaela Simona Popoviciu","doi":"10.3390/diagnostics16193201","DOIUrl":"10.3390/diagnostics16193201","url":null,"abstract":"<p><p><b>Background:</b> Baseline HbA1c is expected to dominate prediction of subsequent HbA1c status; therefore, the clinically relevant question is whether additional routinely available variables provide reproducible incremental value. <b>Methods:</b> This retrospective longitudinal study used 809 records from adults with type 2 diabetes receiving routine outpatient care. Six-month HbA1c was available for 808 participants. The primary outcome was six-month glycemic status (HbA1c < 7.0%). An HbA1c-only benchmark and three fixed blockwise logistic models were compared in the same complete-case cohort (<i>n</i> = 806). Internal validation used 1000 bootstrap resamples and reported optimism-corrected AUC, Brier score, calibration intercept, and calibration slope. Correlations, variance inflation factors (VIFs), nonlinear effects, decision-curve analysis, and a sensitivity analysis restricted to baseline HbA1c ≥ 7.0% were evaluated. <b>Results:</b> At baseline, 215 participants had HbA1c < 7.0%; 179 maintained this status, 206 newly reached <7.0%, 36 moved above the threshold, and 387 remained ≥7.0%. In complete cases, the optimism-corrected AUC was 0.868 (95% CI 0.844-0.892) for HbA1c alone and 0.870 (95% CI 0.848-0.893) for the full model. The corrected AUC difference between the full and HbA1c-only models was 0.001 (95% CI of -0.011 to 0.011). For the full model, the corrected Brier score was 0.146, the calibration intercept was 0.001, and the calibration slope was 0.925. VIFs were low (maximum of 1.33), although the TyG coefficient reversed direction after adjustment and was not interpreted causally. In participants with baseline HbA1c ≥ 7.0% (<i>n</i> = 592 complete cases), corrected AUCs were 0.850 for HbA1c alone and 0.849 for the full model. <b>Conclusions:</b> Baseline HbA1c accounts for nearly all discriminative performance. Added biomarkers and baseline therapeutic classes provide little internally validated incremental value, and the model should not be used for treatment decisions before external validation and prospective evaluation of clinical impact.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Two-Stage Prediction Strategy for Primary Hyperparathyroidism.","authors":"Ruisi Chen, Min Ren, Jingyan Chen, Pin Wang","doi":"10.3390/diagnostics16193200","DOIUrl":"10.3390/diagnostics16193200","url":null,"abstract":"<p><p><b>Background:</b> Primary hyperparathyroidism parathyroid hormone (PTH) hypersecretion is difficult to recognise when calcium is normal and difficult to distinguish from secondary hyperparathyroidism once PTH is found to be elevated. These are separate problems arising at separate points in care. We developed and evaluated two interpretable models corresponding to these decision points using an internal-external validation design. <b>Methods:</b> We analysed 2788 adults undergoing PTH testing across three campuses of one hospital (development <i>n</i> = 1843; internal-external validation <i>n</i> = 445 and <i>n</i> = 500); those with an estimated glomerular filtration rate below 30 mL/min/1.73 m² were excluded. PHPT was adjudicated in 504 (18.1%) by two endocrinologists using biochemistry, imaging and histopathology. Model 1, for use before PTH is measured, comprised total calcium, ln(alkaline phosphatase) and age. Model 2, developed in the Main campus subgroup with PTH above the reference limit (>65 pg/mL, <i>n</i> = 429 of 623), comprised ln(PTH), total calcium and phosphate. <b>Results:</b> Model 1 achieved AUCs of 0.920 in the development cohort and 0.882-0.908 in the validation cohorts; because serum calcium contributed to the outcome definition, these estimates reflect agreement with the reference standard rather than independent diagnostic accuracy. Among participants with elevated PTH, Model 2 achieved an AUC of 0.904 in the development cohort and 0.892 in the pooled validation cohort compared with 0.803 and 0.791 for PTH alone, respectively. In the normocalcaemic subgroup, Model 2 achieved an AUC of 0.790 compared with 0.699 for PTH alone. Applied sequentially, the models referred 18.0-26.1% of participants while capturing 78.1-85.0% of PHPT cases and identified a second-stage subgroup with an observed PHPT prevalence of 93.1-95.1%. <b>Conclusions:</b> This two-stage strategy may support further testing and referral for PHPT using routinely available measurements. Prospective validation in broader clinical populations is required before clinical implementation.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytology, High-Risk HPV Genotyping, and Histology in Cervical Pathology: A Retrospective Cohort Study.","authors":"Maria-Daniela Vasieș Mazilu, Elena-Lavinia Rusu, Jasmina-Sorina Chiriac, Alexandra-Corina Faur, Elena-Rodica Heredea, Veronica-Daniela Chiriac","doi":"10.3390/diagnostics16193204","DOIUrl":"10.3390/diagnostics16193204","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Cervical cancer prevention relies on cytology, high-risk human papillomavirus (HR-HPV) testing, and histological confirmation, but these modalities may disagree. We quantified test concordance and determinants of CIN2+ in a specialized gynecologic referral cohort with very low HPV vaccination coverage. <b>Methods:</b> We retrospectively analyzed 172 women evaluated for suspected or established cervical pathology between 2022 and 2024. Of these, 160 had a definitive HPV result and 130 had histology; histology-based performance analyses used complete cases and are conditional on biopsy verification. Cytology was categorized by the Bethesda system, HR-HPV genotypes were recorded, and histology was dichotomized as CIN2+ versus ≤CIN1. <b>Results:</b> Among 160 women with definitive HPV results, 109 (68.1%) were HPV-positive. HPV-positive women were younger (median 33 vs. 43 years, <i>p</i> < 0.001) and, among biopsied women, more frequently had CIN2+ (70.2% vs. 22.2%, <i>p</i> < 0.001). Cyto-histological agreement was fair (65.0%, κ = 0.32). HPV16/18 was strongly associated with CIN2+ (OR 6.85, 95% CI 2.54-18.49). Within histologically verified complete cases, HPV DNA positivity had the highest apparent sensitivity (91.7%), whereas HPV16/18 had the highest PPV (86.0%). <b>Conclusions:</b> Cytology and HR-HPV testing provide complementary information in this referral-enriched cohort. Because disease prevalence was high and biopsy verification was selective, predictive values and apparent diagnostic-performance estimates should not be extrapolated directly to population screening; external validation in primary-screening populations is required.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Preoperative MRI-Derived Anatomical Parameters with Urinary Continence Recovery After Robot-Assisted Radical Prostatectomy.","authors":"Deniz Öztürk Koçakgöl, Mehmet Eren Öztürk, Muhittin Atar, Hüseyin Koçakgöl, İbrahim Karabulut","doi":"10.3390/diagnostics16193203","DOIUrl":"10.3390/diagnostics16193203","url":null,"abstract":"<p><p><b>Objectives:</b> This study evaluated the association of patient age and preoperative prostate MRI-derived anatomical parameters with postoperative urinary incontinence (UI) and urinary continence (UC) recovery after robot-assisted radical prostatectomy (RARP). <b>Methods:</b> We retrospectively included 118 patients who underwent RARP between 2022 and 2024 and had preoperative prostate MRI. Patient age and continence status at 1, 3, 6, and 12 months were obtained from medical records. Levator ani muscle (LAM), obturator internus muscle (OIM), and pubococcygeus muscle thicknesses were measured at their thickest points on axial and coronal T2-weighted images. Membranous urethral width (MUW), length (MUL), and angle (MUA) were measured, and prostate volume was calculated. UC was defined as no pad use or one safety pad per day (used for reassurance or for occasional minimal drops of urine), whereas UI was defined as the use of one or more pads per day that became wet because of urine leakage. Associations were evaluated using group comparisons, Kaplan-Meier analysis, and exploratory Cox and logistic regression models. <b>Results:</b> UC rates at 1, 3, 6, and 12 months were 32.2%, 54.2%, 73.7%, and 91.5%, respectively, while 8.5% of patients remained incontinent at 12 months. At 3 months, patients with UC differed significantly from those with UI in age, MUA, and LAM thickness. Comparisons among patients who achieved UC at different postoperative time points and those with UI at 12 months demonstrated significant differences in LAM thickness, MUL, and MUA (all <i>p</i> < 0.05). In multivariable Cox regression, higher MUA (hazard ratio [HR] 1.43 per 10°), thicker LAM (coronal HR 1.30 and axial HR 1.28 per mm), and younger age (HR 0.85 per 5 years) were associated with earlier continence recovery, whereas MUL was not. Prostate volume, MUW, and pubococcygeus muscle thickness were not associated with continence outcomes. <b>Conclusions:</b> Preoperative MRI-derived anatomical parameters, particularly MUA and LAM thickness, together with patient age, were associated with urinary continence recovery after RARP, and the associations of MUA and LAM thickness remained significant after multivariable adjustment in the time-to-event analysis. These exploratory findings are hypothesis-generating; clinical confounders could not be accounted for, and validation in prospective studies is required before these parameters can be considered for clinical use.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental Predictive Value of Post-Baseline Surgery and the Impact of Temporal Coding on Mortality Associations in Infective Endocarditis: A Temporally Validated Cohort Study.","authors":"Banu Karaca, Aykan Çelik, Mert İnan, Berke Ege, Mustafa Karaca","doi":"10.3390/diagnostics16193209","DOIUrl":"10.3390/diagnostics16193209","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Risk prediction in infective endocarditis (IE) may be compromised when treatments occurring after the initial evaluation are incorporated as though they were baseline predictors. Surgical treatment is inherently time-dependent, yet subsequent surgery has been incorporated as a static predictor in contemporary prognostic models, potentially affecting both predictive performance and treatment-outcome associations. We evaluated whether adding subsequent surgery improves mortality prediction beyond information obtained during the initial index-episode evaluation and examined how temporal representation of surgery influences its association with mortality. &lt;b&gt;Methods:&lt;/b&gt; We retrospectively studied 293 consecutive patients with IE. The primary outcome was 180-day all-cause mortality. Model A incorporated seven prespecified predictors obtained during the initial index-episode evaluation: age, NYHA functional class, hemoglobin, blood urea nitrogen, left ventricular ejection fraction, severe regurgitation, and C-reactive protein. Model B additionally incorporated a binary indicator of surgery within 180 days. Predictive performance was assessed using time-dependent AUC, Brier score, 1000-replicate bootstrap cross-validation, and temporal validation using 2008-2017 as the derivation period and 2018-2026 as the validation period. Surgery-mortality associations were compared using fixed baseline and time-dependent exposure definitions. &lt;b&gt;Results:&lt;/b&gt; Ninety-two patients (31.4%) died within 180 days, and 122 (41.6%) underwent surgery within 180 days. In the complete-case cohort (&lt;i&gt;n&lt;/i&gt; = 278), Model A had an apparent AUC of 0.792 and a bootstrap cross-validated AUC of 0.759. Adding future surgery produced no detectable improvement in apparent discrimination (AUC 0.793 vs. 0.792; ΔAUC +0.001, 95% CI -0.018 to +0.019) or after bootstrap cross-validation (AUC 0.749 vs. 0.759; ΔAUC -0.010, 95% CI -0.057 to +0.014). In temporal validation, AUCs were 0.731 for Model A and 0.733 for Model B. Mean predicted 180-day mortality was 27.3% versus an observed Kaplan-Meier risk of 34.7% (95% CI 25.5-42.8%); the observed-minus-predicted difference was +7.5 percentage points (bootstrap 95% CI -2.4 to +18.8). Fixed baseline coding yielded an adjusted HR of 0.71 (95% CI 0.44-1.17) in all 278 complete cases and 0.58 (95% CI 0.34-0.99) after excluding five same-day surgery/death records; in the corresponding 273-patient matched sample, time-dependent coding yielded an HR of 1.44 (95% CI 0.83-2.49). Exploratory phase-specific analyses suggested higher mortality during the early postoperative period, but the magnitude was sensitive to same-day event handling. &lt;b&gt;Conclusions:&lt;/b&gt; In this cohort, adding a binary indicator of subsequent surgery to the prespecified seven-predictor baseline model produced no detectable improvement in 180-day mortality prediction. In contrast, the estimated surgery-mortality association changed substantially according to temp","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a Single Thermal Cycling Multiplex RT-qPCR Assay for Rapid Arbovirus Detection.","authors":"Róger J Costa, Andreas Stocker, Cleyde Marconi, Gubio S Campos, Silvia Sardi, Abevailton Miranda, Carlos Brites, Wei-Kung Wang, Eduardo M Netto","doi":"10.3390/diagnostics16193205","DOIUrl":"10.3390/diagnostics16193205","url":null,"abstract":"<p><p><b>Background:</b> The co-circulation of multiple arboviruses with similar clinical presentations poses a significant challenge for public health surveillance. This study aimed to develop and clinically validate a novel multiplex RT-qPCR assay for the simultaneous detection of five arboviruses in three reactions. <b>Methods:</b> A diagnostic accuracy study was conducted in Salvador, Brazil. Evaluation was performed using 254 prospective serum samples and 34 archived positive samples. The primers and probes for the assay were designed <i>in silico</i>, all targeting highly conserved regions of Dengue (DENV), Zika (ZIKV), Chikungunya (CHIKV), Oropouche (OROV), and West Nile (WNV) viruses. The protocol was optimized in three reactions with a single thermal cycle, comprising a tetraplex reaction (DENV, CHIKV, ZIKV, and hRNAseP, an endogenous control) and two singleplex reactions (OROV and WNV). <b>Results:</b> In prospective analysis, the assay identified 45 DENV, 3 CHIKV, and 9 OROV-positive cases. Diagnostic accuracy for DENV and CHIKV was 96% (95% CI: 93.3-98.0%), successfully detecting four DENV cases missed by the reference standard. Furthermore, incorporating OROV enabled the identification of nine cases that conventional triplex protocols would have overlooked. <b>Conclusion:</b> This single-cycling multiplex RT-qPCR assay enhances epidemiological surveillance by expanding detection beyond traditional triplex targets to include OROV and WNV. This operational optimization reduces turnaround times and prevents the underdiagnosis of emerging arboviruses, serving as a robust diagnostic tool for endemic regions.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664199/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CSFINet-Based Multimodal MRI Image Segmentation and Survival Prediction.","authors":"Jia-Lien Hsu, Pei-Yu Yu","doi":"10.3390/diagnostics16193210","DOIUrl":"10.3390/diagnostics16193210","url":null,"abstract":"<p><p><b>Background</b>: Brain tumors are highly lethal malignant neoplasms, for which accurate tumor segmentation and survival-day prediction are critical to treatment planning and prognostic assessment. This study establishes an exploratory two-stage analytical framework spanning multimodal MRI tumor segmentation and survival-day prediction. <b>Methods</b>: The study is based on the BraTS 2020 multimodal MRI dataset, employing four imaging modalities-T1, T1ce, T2, and FLAIR-with patient age and extent-of-resection status as candidate clinical features. The 235 cases with survival labels were split at the patient level (188 training, 47 test; single 80:20 split). In the first stage, CSFINet is used for brain tumor segmentation; in the second stage, the resulting binary whole-tumor mask, age, and resection status serve as inputs for survival-day prediction. The survival models are trained on the ground-truth whole-tumor masks but evaluated on the masks predicted by CSFINet, and the survival training runs were not seeded. Four models-image-only, image with age, image with resection status, and image with both-are constructed for ablation experiments, and Gradient SHAP is introduced for interpretability analysis. <b>Results</b>: CSFINet achieves a Mean Dice, Mean Precision, and Mean Recall of 0.7849±0.1937, 0.8739±0.1978, and 0.7480±0.1936, compared with 0.5084, 0.8676, and 0.3822 for a U-Net baseline trained in this study under an identical configuration. The gains are in Dice and recall; the precision difference (+0.0063, 95% CI -0.0601 to 0.1086) is not distinguishable from zero. This comparison is internal to the present study; published BraTS 2020 results were obtained under different evaluation protocols and are not directly comparable. The model combining imaging features with age yields the lowest error, achieving a mean absolute error of 251.69 days (95% CI [186.56, 336.79])-lower than the 279.41 days obtained by the image-only model-whereas incorporating resection status does not lead to further improvement. <b>Conclusions</b>: CSFINet improves whole-tumor segmentation relative to this identically configured U-Net baseline-not relative to the published state of the art-and the inclusion of age was associated with a lower survival-day prediction error in this study. The survival findings are exploratory and cohort-specific: an MAE of 252 days is roughly 57% of the reported median survival of glioblastoma and is not clinically actionable, and the web interface is a research prototype. This study establishes an integrated analytical pipeline spanning tumor segmentation, survival-day prediction, and result visualization, serving as a preliminary reference for brain tumor image analysis and prognostic assessment. These are exploratory, single-cohort associations obtained from BraTS 2020; they do not establish a causal relationship between the clinical variables and survival, and they have not been externally validated.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-Phase Occupational Screening in Coal-Fired Power Plant Workers: Anamnestic Risk Stratification and Targeted Low-Dose CT Findings.","authors":"Adrian Cranta, Eugen Osiac, Dan Ionuț Gheonea, Costin Teodor Streba, Carmen Nicoleta Oancea, Ioana Andreea Gheonea, Madalin Niculici, Cristina Ciofiac, Daiana Petrescu, Mircea-Sebastian Șerbănescu","doi":"10.3390/diagnostics16193202","DOIUrl":"10.3390/diagnostics16193202","url":null,"abstract":"<p><p><b>Background:</b> Employees at coal-fired power plants experience cumulative occupational exposure to respirable particulates alongside a high prevalence of smoking, both contributing to chronic respiratory disease and elevated lung cancer risk, and organized-screening implementation data remain scarce in this specific industrial setting outside asbestos-exposed cohorts. We evaluated a two-step occupational screening strategy integrating an anamnestic questionnaire with targeted low-dose CT (LDCT) imaging, assessing risk distribution, structured imaging findings, and the discriminative value of questionnaire-based triage relative to its underlying continuous predictors. <b>Methods:</b> In this cross-sectional study, all workers at a coal-fired power plant completed a structured questionnaire (F1) and were classified as high-risk or non-high-risk using a predefined eligibility rule (respiratory symptoms, or age ≥ 50 years with current/former smoking). All workers were invited to voluntary LDCT (F2), interpreted using Lung-RADS v2022 with structured emphysema and coronary artery calcium (CAC) assessment. Associations were assessed using Fisher's exact tests, multivariable logistic regression, and ROC analysis with DeLong's test; voluntary LDCT uptake was characterized with a multivariable propensity model. <b>Results:</b> Among 870 screened workers, 364 (41.8%) were high-risk. LDCT uptake was higher among high-risk workers (130/364, 35.7%) than non-high-risk workers (56/506, 11.1%), yielding 186 examinations. Only 14/186 (7.5%) had Lung-RADS ≥ 3. High-risk status was associated with higher prevalence of any nodule (80.8% vs. 62.5%; OR 2.52) and CAC (46.9% vs. 14.3%; OR 5.30); a composite abnormality outcome was present in 92.3% vs. 69.6% (OR 5.23). Only age (OR 1.11/year) and ever-smoking status (OR 4.38) independently predicted abnormalities on multivariable analysis; dichotomized risk classification showed reduced discrimination for CAC versus a continuous age-smoking model (AUC 0.647 vs. 0.779). <b>Conclusions:</b> Questionnaire-based triage effectively enriched the LDCT-screened population for smoking-related and cardiometabolic risk. Age and smoking history, rather than the full questionnaire, principally drove imaging abnormalities, supporting an integrated occupational model combining lung cancer screening with COPD and cardiovascular risk management.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149192098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Initial Validation of a Statistical Image Analysis Framework for Quantitative Bone SPECT/CT in Patients with Prostate Cancer.","authors":"Kenta Miwa, Noriaki Miyaji, Tensho Yamao, Kosuke Yamashita, Tetsuo Hosoya, Kazunori Kawakami","doi":"10.3390/diagnostics16193206","DOIUrl":"10.3390/diagnostics16193206","url":null,"abstract":"<p><p><b>Background/Objectives:</b> Quantitative bone single-photon emission computed tomography/computed tomography (SPECT/CT) enables standardized uptake value (SUV)-based assessment of skeletal tracer uptake; however, SUV does not directly indicate the degree of deviation from the physiological distribution at the corresponding anatomical location. This study aimed to develop a statistical image analysis software framework for quantitative bone SPECT/CT and perform its initial validation. <b>Methods:</b> Eighty-one male patients who underwent quantitative bone SPECT/CT for suspected bone metastases from prostate cancer were retrospectively analyzed, including 49 without and 32 with bone metastases. The developed software integrated CT-based anatomical standardization, construction of a bone-specific normal database (NDB), and voxel-wise Z-score mapping. Thirty successfully standardized subjects without bone metastases were used to construct the NDB. Preliminary clinical validation included 75 reference skeletal regions of interest (ROIs) in the lumbar vertebrae and iliac bones from three independent subjects and 74 metastatic lesions from 19 patients. <b>Results:</b> Anatomical standardization was successful in 33/49 subjects without bone metastases and 19/32 patients with bone metastases. NDBs comprising 8, 16, and 30 subjects showed no significant difference in the standard deviation-to-mean ratio (<i>p</i> = 0.37). The developed software successfully generated voxel-wise Z-score maps representing deviations from the reference distribution at corresponding skeletal locations. Z-score_max showed a strong positive correlation with SUV_max in metastatic lesions (ρ = 0.95, <i>p</i> < 0.0001), and all 74 metastatic lesions showed Z-score_max > 2. <b>Conclusions:</b> The developed software enables statistical analysis of quantitative bone SPECT/CT using anatomical standardization, a bone-specific NDB, and voxel-wise Z-score mapping. Z-score mapping provides quantitative information relative to the location-specific reference distribution and might complement conventional SUV-based assessment. Further validation using larger and independent cohorts is required to determine its clinical value.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression Profiles of hsa-miR-4715-3p and hsa-miR-5000-3p in Breast Cancer: Findings from Functional and Regulatory Network Analyses.","authors":"Aysegul Cihangor, Deniz Mihcioglu, Turkan Gurer, Alper Aytekin, Filiz Ozbas Gerceker","doi":"10.3390/diagnostics16193199","DOIUrl":"10.3390/diagnostics16193199","url":null,"abstract":"<p><p><b>Background/Objective:</b> In this study, we aimed to determine the expression profiles of hsa-miR-4715-3p and hsa-miR-5000-3p in breast tumor tissues and to investigate their possible biological and regulatory relationships through integrated bioinformatics analyses. <b>Methods:</b> Tumor and adjacent non-tumor breast tissues were obtained from 38 patients with breast cancer, and the expression levels of hsa-miR-4715-3p and hsa-miR-5000-3p were determined using qRT-PCR. To evaluate the functional characteristics of miRNAs, GO and KEGG enrichment analyses were performed. Additionally, to conduct a more comprehensive evaluation of the regulatory networks associated with both miRNAs, TF-miRNA interactions, target genes, TF functions, and disease associations were examined. <b>Results:</b> hsa-miR-4715-3p was significantly downregulated, whereas hsa-miR-5000-3p was markedly upregulated in tumor tissues compared with adjacent non-tumor tissues (both <i>p</i> < 0.001). GO analysis revealed enrichment in metabolic, biosynthetic, and gene regulatory processes, while KEGG analysis highlighted the TGF-beta signaling pathway. TF network analysis identified shared regulatory TFs for both miRNAs, all of which were associated with breast cancer. <b>Conclusions:</b> hsa-miR-4715-3p and hsa-miR-5000-3p showed distinct expression patterns in breast tumor tissues. Their association with signaling and transcriptional networks relevant to breast cancer suggests that these miRNAs may represent underexplored components of breast cancer biology. The findings support further investigation of hsa-miR-4715-3p and hsa-miR-5000-3p; however, validation in independent patient cohorts and functional studies are necessary to establish their biological and potential clinical significance.</p>","PeriodicalId":11225,"journal":{"name":"Diagnostics","volume":"16 19","pages":""},"PeriodicalIF":3.8,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13664427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}